The Risk of CVDs from Desalinated Seawater: A Nested Case-Control Study
Abstract
:1. Introduction
2. Population and Methods
2.1. Study Sites
2.2. Study Design and Population
2.3. Field Investigation
2.3.1. Questionnaire
2.3.2. Urine Sample Collection
2.4. Quality Control
2.5. Statistical Analysis
3. Results
3.1. General Information in the Case and Control Groups
3.2. Desalinated Water Intake and Calcium and Magnesium Concentrations in Urine
3.3. CVDs Risk Factors
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Connor, R.; Coates, D.; Uhlenbrook, S.; Koncagül, E. The United Nations World Water Development Report 2018: Nature-Based Solutions for Water; Executive Summary; United Nations Development Programme: New York, NY, USA, 2018. [Google Scholar]
- Liu, Y.M. Status of Water Resources and Developing Countermeasures of Efficient Water-saving Agriculture in China. Inf. Agric. Sci. Technol. 2020, 16, 80–81, 83. [Google Scholar] [CrossRef]
- Jones, E.; Qadir, M.; van Vliet, M.T.H.; Smakhtin, V.; Kang, S.M. The state of desalination and brine production: A global outlook. Sci. Total Environ. 2019, 657, 1343–1356. [Google Scholar] [CrossRef] [PubMed]
- Sahin, O.; Stewart, R.A.; Helfer, F. Bridging the Water Supply–demand Gap in Australia: Coupling Water Demand Efficiency with Rain-independent Desalination Supply. Water Resour. Manag. 2015, 29, 253–272. [Google Scholar] [CrossRef] [Green Version]
- Kusuma, B.; Octastefani, T. Water Governance of Singapore in Achieving Sustainable Water Security. SSRN Electron. J. 2016, 7. [Google Scholar] [CrossRef] [Green Version]
- Martínez-Alvarez, V.; Maestre-Valero, J.F.; González-Ortega, M.J.; Gallego-Elvira, B.; Martin-Gorriz, B. Characterization of the Agricultural Supply of Desalinated Seawater in Southeastern Spain. Water 2019, 11, 1233. [Google Scholar] [CrossRef] [Green Version]
- Ministry of Natural Resources of the People’s Republic of China. 2019 National Seawater Utilization Report. Natl. Land Resour. Inf. 2020, 20, 40–48. [Google Scholar]
- Spungen, J.H.; Goldsmith, R.; Stahl, Z.; Reifen, R. Desalination of water: Nutritional considerations. Isr. Med. Assoc. J. 2013, 15, 164–168. [Google Scholar] [PubMed]
- World Health Organization (WHO). Cardiovascular Diseases (CVDs). Available online: https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (accessed on 28 October 2021).
- Momeni, M.; Gharedaghi, Z.; Amin, M.M.; Poursafa, P.; Mansourian, M. Does water hardness have preventive effect on cardiovascular disease? Int. J. Prev. Med. 2014, 5, 159–163. [Google Scholar]
- Kousa, A.; Havulinna, A.; Moltchanova, E.; Taskinen, O.; Nikkarinen, M.; Salomaa, V.; Karvonen, M. Magnesium in Well Water and the Spatial Variation of Acute Myocardial Infarction Incidence in Rural Finland. Appl. Geochem. 2008, 23, 632–640. [Google Scholar] [CrossRef]
- Monarca, S.; Zerbini, I.; Simonati, C.; Gelatti, U. Drinking water hardness and chronic degenerative diseases. II. Cardiovascular diseases. Ann. Ig. 2003, 15, 41–56. [Google Scholar]
- Jiang, L.; He, P.; Chen, J.; Liu, Y.; Liu, D.; Qin, G.; Tan, N. Magnesium Levels in Drinking Water and Coronary Heart Disease Mortality Risk: A Meta-Analysis. Nutrients 2016, 8, 5. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Leurs, L.J.; Schouten, L.J.; Mons, M.N.; Goldbohm, R.A.; van den Brandt, P.A. Relationship between tap water hardness, magnesium, and calcium concentration and mortality due to ischemic heart disease or stroke in The Netherlands. Environ. Health Perspect. 2010, 118, 414–420. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Morris, R.W.; Walker, M.; Lennon, L.T.; Shaper, A.G.; Whincup, P.H. Hard drinking water does not protect against cardiovascular disease: New evidence from the British Regional Heart Study. Eur. J. Prev. Cardiol. 2008, 15, 185–189. [Google Scholar] [CrossRef] [PubMed]
- Yang, X.X. Water Quality Monitoring and Health Survey in Typical Area Using Desalinated Seawater as Drinking Water. Master’s Thesis, Chinese Center for Disease Control and Prevention, Beijing, China, 2016. [Google Scholar]
- Zhang, J.P.; Zhang, J.Z.; Wu, J.R.; Ding, B.Q.; Huang, F.M.; Zou, S.Y. Quality detection and hygienic analysis of reverse osmosis desalinated seawater in islets. Chin. J. Health Lab. Technol. 2012, 22, 255–257. [Google Scholar]
- GJB1335-92; Hygienic Standard of Mineralization for Drinking Water with Low Mineral Level. The Chinese People’s Liberation Army General Logistics Department of the Ministry of Health: Beijing, China, 1992.
- Zhang, Y.L.; Ying, N.H.; Zheng, W.D.; Fang, H.J.; Ni, H.J. Study and analysis of desalinated water quality in Shengsi County. Chin. J. Health Lab. Technol. 2007, 17, 371–372, 384. [Google Scholar] [CrossRef]
- Roth, G.A.; Abate, D.; Abate, K.H.; Abay, S.M.; Abbafati, C.; Abbasi, N. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018, 392, 1736–1788. [Google Scholar] [CrossRef] [Green Version]
- Cao, X.X.; Xu, C.J.; Hou, Y.B.; Wang, Y.; Fan, N.; Xu, F.S.; Wang, Y.G. The epidemic trend and prediction of chronic diseases with high incidence in China from 1990 to 2025. Chin. J. Prev. Control Chronic Dis. 2020, 28, 14–19. [Google Scholar] [CrossRef]
- WHO. WHO. WHO Guidelines Approved by the Guidelines Review Committee. In Guidelines for Drinking-Water Quality: Fourth Edition Incorporating the First Addendum; World Health Organization: Geneva, Switzerland, 2017. [Google Scholar]
- Koren, G.; Shlezinger, M.; Katz, R.; Shalev, V.; Amitai, Y. Seawater desalination and serum magnesium concentrations in Israel. J. Water Health 2017, 15, 296–299. [Google Scholar] [CrossRef]
- Larsson, S.C. Urinary magnesium excretion as a marker of heart disease risk. Am. J. Clin. Nutr. 2013, 97, 1159–1160. [Google Scholar] [CrossRef] [Green Version]
- Elin, R.J. Assessment of magnesium status for diagnosis and therapy. Magnes. Res. 2010, 23, S194–S198. [Google Scholar] [CrossRef]
- Djurhuus, M.S.; Gram, J.; Petersen, P.H.; Klitgaard, N.A.; Bollerslev, J.; Beck-Nielsen, H. Biological variation of serum and urinary magnesium in apparently healthy males. Scand. J. Clin. Lab. Investig. 1995, 55, 549–558. [Google Scholar] [CrossRef] [PubMed]
- Trauninger, A.; Pfund, Z.; Koszegi, T.; Czopf, J. Oral magnesium load test in patients with migraine. Headache 2002, 42, 114–119. [Google Scholar] [CrossRef] [PubMed]
- Joosten, M.M.; Gansevoort, R.T.; Mukamal, K.J.; van der Harst, P.; Geleijnse, J.M.; Feskens, E.J.; Navis, G.; Bakker, S.J.; Group, P.S. Urinary and plasma magnesium and risk of ischemic heart disease. Am. J. Clin. Nutr. 2013, 97, 1299–1306. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Li, Y. Study on the Present Situation and Health Risk of Desalinated Water in an Island County of Zhejiang Province. Master’s Thesis, Chinese Center for Disease Control and Prevention, Beijing, China, 2019. [Google Scholar]
- Wang, Z.; Hu, S. Interpretation of Report on Cardiovascular Health and Diseases in China 2020. Chin. J. Cardiovasc. Med. 2021, 26, 209–218. [Google Scholar] [CrossRef]
- Shi, Q.W.; Dai, N.B.; Sheng, H.Y.; Qin, Y.; Su, J.; Cui, L.; Luo, P.F.; Du, W.C.; Zhou, J.Y. Correlation between drinking frequency and the high-risk of cardiovascular disease. Chin. J. Prev. Control Chronic Dis. 2019, 27, 171–175. [Google Scholar] [CrossRef]
- Fu, Y.; Liu, S.J.; Liu, T.; Hou, Z.L.; Li, L.; Jia, Y.Y. Epidemiological characteristics and influencing factors of high risk population of cardiovascular disease in Jilin Province. Chin. J. Dis. Control Prev. 2020, 24, 1297–1301. [Google Scholar] [CrossRef]
- Baghai, T.C.; Varallo-Bedarida, G.; Born, C.; Häfner, S.; Schüle, C.; Eser, D.; Zill, P.; Manook, A.; Weigl, J.; Jooyandeh, S.; et al. Classical Risk Factors and Inflammatory Biomarkers: One of the Missing Biological Links between Cardiovascular Disease and Major Depressive Disorder. Int. J. Mol. Sci. 2018, 19, 1704. [Google Scholar] [CrossRef] [Green Version]
Variable | Cases (n = 140) | Controls (n = 140) | Total | Statistic | p | |
---|---|---|---|---|---|---|
χ2 | t | |||||
Marital status | 0.55 | 0.45 | ||||
Married | 92 (65.71%) | 86 (61.43%) | 178 (63.57%) | |||
Other | 48 (34.29%) | 54 (38.57%) | 102 (36.43%) | |||
Education | 0.43 | 0.51 | ||||
Primary and below | 130 (92.86%) | 127 (90.71%) | 257 (91.79%) | |||
Junior high school and above | 10 (7.14%) | 13 (9.29%) | 23 (8.21%) | |||
OccupationΔ | 1.50 | 0.96 | ||||
1 | 8 (5.71%) | 9 (6.43%) | 17 (6.07%) | |||
2 | 8 (5.71%) | 6 (4.29%) | 14 (5.00%) | |||
3 | 5 (3.57%) | 6 (4.29%) | 11 (3.93%) | |||
4 | 62 (44.29%) | 59 (42.14%) | 121 (43.21%) | |||
5 | 2 (1.43%) | 2 (1.43%) | 4 (1.43%) | |||
6 | 55 (39.29%) | 58 (41.43%) | 113 (40.36%) | |||
Economic status (ten thousand RMB)※ | 2.91 | 0.41 | ||||
<2 | 105 (75.00%) | 113 (80.71%) | 218 (77.86%) | |||
2- | 25 (17.86%) | 17 (12.14%) | 42 (15.00%) | |||
5- | 6 (4.29%) | 5 (3.57%) | 11 (3.93%) | |||
8- | 4 (2.86%) | 5 (3.57%) | 9 (3.21%) | |||
Height (cm) | 159.72 ± 7.53 | 159.96 ± 7.25 | 159.79 ± 8.30 | 0.33 | 0.75 | |
Weight (kg) | 60.49 ± 10.93 | 57.28 ± 9.66 | 60.45 ± 9.38 | −3.07 | <0.01 # |
Desalinated Water Intake | Cases (n = 140) | Controls (n = 140) | Total (n = 280) | χ2 | p |
---|---|---|---|---|---|
Yes | 19 (13.57%) | 18 (12.86%) | 37 (13.21%) | 0.032 | 0.86 |
No | 121 (86.43%) | 122 (87.14%) | 243 (86.79%) |
Variable | Cases | Controls | Total | t | p |
---|---|---|---|---|---|
Calcium in urine | 211.55 ± 145.86 | 200.41 ± 134.63 | 206.19 ± 137 | 0.399 | 0.53 |
Magnesium in urine | 117.16 ± 62.59 | 119.80 ± 59.88 | 118.88 ± 31.3 | 0.527 | 0.47 |
Variable | No Drink Desalinated Water | Drink Desalinated Water | t | p | ||
---|---|---|---|---|---|---|
n | n | |||||
Calcium in urine | 203 | 205.00 ± 140.63 | 37 | 220.47 ± 126.15 | −0.59 | 0.56 |
Magnesium in urine | 203 | 119.94 ± 62.56 | 37 | 108.92 ± 40.74 | 1.31 | 0.20 |
Variable | Cases (n = 140) | Controls (n = 140) | Wald χ2 | OR | 95% CI | p |
---|---|---|---|---|---|---|
Location | ||||||
H town | 91 (65.00%) | 104 (74.29%) | ||||
G town | 49 (35.00%) | 36 (25.71%) | 0.44 | 0.80 | 0.42–1.54 | 0.51 |
Marital status | ||||||
Married | 92 (65.71%) | 86 (61.43%) | ||||
Other | 48 (34.29%) | 54 (38.57%) | 2.26 | 1.69 | 0.83–3.35 | 0.13 |
Education | ||||||
Primary and below | 130 (92.86%) | 127 (90.71%) | ||||
Junior high school and above | 10 (7.14%) | 13 (9.29%) | 0.24 | 0.78 | 0.30–2.01 | 0.61 |
Economic status (ten thousand RMB) | ||||||
<2 | 105 (75.00%) | 113 (80.71%) | ||||
2- | 25 (17.86%) | 17 (12.14%) | 0.81 | 1.39 | 0.68–2.87 | 0.37 |
5- | 6 (4.29%) | 5 (3.57%) | 0.53 | 1.61 | 0.45–5.76 | 0.47 |
8- | 4 (2.86%) | 5 (3.57%) | 1.08 | 0.42 | 0.08–2.17 | 0.30 |
Variable | Cases (n = 140) | Controls (n = 140) | Wald χ2 | OR | 95% CI | p |
---|---|---|---|---|---|---|
Desalinated water intake | ||||||
No | 121 (86.43%) | 122 (87.14%) | ||||
Yes | 19 (13.57%) | 18 (12.86%) | 0.03 | 0.94 | 0.49–1.83 | 0.87 |
BMI | ||||||
normal | 85 (60.71%) | 91 (65.00%) | ||||
overweight | 43 (30.71%) | 41 (29.29%) | 1.54 | 1.42 | 0.82–2.46 | 0.21 |
obesity | 12 (8.57%) | 8(5.71%) | 4.58 | 3.60 | 1.11–11.64 | 0.03 # |
Physical activity | ||||||
No | 91 (65.00%) | 74 (52.86%) | ||||
Yes | 49 (35.00%) | 66 (47.14%) | 0.43 | 1.02 | 0.95–1.10 | 0.51 |
Family history of Hypertension | ||||||
No | 114 (81.43%) | 123 (87.86%) | ||||
Yes | 26 (18.57%) | 17 (12.14%) | 6.30 | 2.46 | 1.22–4.95 | 0.01# |
Family history of diabetes | ||||||
No | 136 (97.14%) | 137 (97.86%) | ||||
Yes | 4 (2.86%) | 3 (2.14%) | 2.75 | 6.00 | 0.72–49.84 | 0.10 |
History of Hypertension | ||||||
No | 46 (32.86%) | 54 (38.57%) | ||||
Yes | 94 (67.14%) | 86 (61.43%) | 18.99 | 3.71 | 2.06–6.70 | <0.01# |
History of diabetes | ||||||
No | 117 (83.57%) | 119 (85.00%) | ||||
Yes | 23 (16.43%) | 21 (15.00%) | 6.00 | 2.75 | 1.22–6.18 | 0.01# |
History of hyperlipidemia | ||||||
No | 127 (90.71%) | 132 (94.29%) | ||||
Yes | 13 (9.29%) | 8 (5.71%) | 3.70 | 4.50 | 0.97–20.83 | 0.05 |
Health care products intake | ||||||
No | 111 (79.29%) | 114 (81.43%) | ||||
Yes | 29 (20.71%) | 26 (18.57%) | 0.11 | 1.11 | 0.59–2.10 | 0.75 |
Cooking oil consumption | ||||||
≤30 g/day | 76 (54.29%) | 70 (50.00%) | ||||
>30 g/day | 64 (45.71%) | 70 (50.00%) | 1.32 | 0.74 | 0.45–1.23 | 0.25 |
Salt consumption | ||||||
≤10 g/day | 100 (71.43%) | 105 (75.00%) | ||||
>10 g/day | 40 (28.57%) | 35 (25.00%) | 0.02 | 0.96 | 0.55–1.68 | 0.89 |
Smoking status | ||||||
Never | 93 (66.43%) | 85 (60.71%) | ||||
Ever | 13 (9.29%) | 16 (11.43%) | 1.81 | 1.92 | 0.74–4.98 | 0.18 |
Current | 34 (24.29%) | 39 (27.86%) | 0.90 | 1.49 | 0.65–3.39 | 0.34 |
Second-hand smoke exposure | ||||||
hardly | 106 (75.71%) | 112 (80.00%) | ||||
Yes | 34 (24.29%) | 28 (20.00%) | 0.13 | 0.88 | 0.43–1.73 | 0.71 |
Alcohol drinking | ||||||
No | 92 (65.71%) | 138 (98.57%) | ||||
Yes | 48 (34.29%) | 29 (20.71%) | 3.98 | 1.93 | 1.01–3.68 | 0.05 # |
Tea drinking | ||||||
No | 128 (91.43%) | 130 (92.86%) | ||||
Yes | 12 (8.57%) | 10 (7.14%) | 0.21 | 1.15 | 0.63–2.10 | 0.65 |
Irritability | ||||||
No | 79 (56.43%) | 100 (71.43%) | ||||
Yes | 61 (43.57%) | 40 (28.57%) | 19.13 | 4.60 | 2.32–9.11 | <0.01 # |
Anxious | ||||||
No | 127 (90.71%) | 129 (92.14%) | ||||
Yes | 13 (9.29%) | 11 (7.86%) | 1.28 | 1.71 | 0.68–4.33 | 0.26 |
Depression | ||||||
No | 104 (74.29%) | 113 (80.71%) | ||||
Yes | 36 (25.71%) | 27 (19.29%) | 5.33 | 2.07 | 1.12–3.83 | 0.02 # |
Variable | Wald χ2 | OR | 95% CI | p |
---|---|---|---|---|
BMI | ||||
Obesity vs. normal | 4.09 | 5.38 | 1.05–27.45 | 0.04 |
Physical activity | ||||
Yes vs. No | 7.22 | 0.35 | 0.16–0.75 | 0.01 |
History of hypertension | ||||
Yes vs. No | 9.28 | 3.61 | 1.58–8.25 | <0.01 |
Alcohol drinking | ||||
Yes vs. No | 3.98 | 2.57 | 1.02–6.47 | 0.05 |
Irritability | ||||
Yes vs. No | 12.08 | 4.30 | 1.93–9.60 | <0.01 |
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Shi, J.; Liu, Y.; Wang, Q.; Hu, X.; Ye, B.; Dong, S. The Risk of CVDs from Desalinated Seawater: A Nested Case-Control Study. Int. J. Environ. Res. Public Health 2022, 19, 7422. https://doi.org/10.3390/ijerph19127422
Shi J, Liu Y, Wang Q, Hu X, Ye B, Dong S. The Risk of CVDs from Desalinated Seawater: A Nested Case-Control Study. International Journal of Environmental Research and Public Health. 2022; 19(12):7422. https://doi.org/10.3390/ijerph19127422
Chicago/Turabian StyleShi, Juexin, Yuan Liu, Qin Wang, Xiaojian Hu, Bixiong Ye, and Shaoxia Dong. 2022. "The Risk of CVDs from Desalinated Seawater: A Nested Case-Control Study" International Journal of Environmental Research and Public Health 19, no. 12: 7422. https://doi.org/10.3390/ijerph19127422